Lung cancer (LC) is the second most common cancer and the leading cause of cancer deaths in the U.S. Insulin therapy, a key treatment for managing Type 2 Diabetes Mellitus (T2DM), is associated with increased LC risk. The impact of non-insulin antidiabetic drugs, particularly GLP-1 receptor agonists (GLP-1RAs), on LC risk is not well understood. This study evaluated LC risk in T2DM patients, comparing seven non-insulin antidiabetic agents to insulin. Using the TriNetX Analytics platform, we analyzed the de-identified electronic health records of 1,040,341 T2DM patients treated between 2005 and 2019, excluding those with prior antidiabetic use or LC diagnoses. We calculated hazard ratios and confidence intervals for LC risk and used propensity score matching to control for confounding factors. All non-insulin antidiabetic drugs, except alpha-glucosidase inhibitors, were associated with significantly reduced LC risk compared to insulin, with GLP-1RAs showing the greatest reduction (HR: 0.49, 95% CI: 0.41, 0.59). GLP-1RAs were consistently associated with lowered LC risk across all histological types, races, genders, and smoking statuses. These findings suggest that non-insulin antidiabetic drugs, particularly GLP-1RAs, may be preferable for managing T2DM while reducing LC risk.
肺癌是美国第二大常见癌症及癌症相关死亡的首要原因。胰岛素治疗作为2型糖尿病管理的关键手段，其使用与肺癌风险升高相关。非胰岛素类降糖药物，特别是胰高血糖素样肽-1受体激动剂对肺癌风险的影响尚未明确。本研究通过对比七种非胰岛素类降糖药物与胰岛素，评估了2型糖尿病患者的肺癌风险。利用TriNetX分析平台，我们分析了2005年至2019年间接受治疗的1,040,341例2型糖尿病患者的去标识化电子健康记录，并排除了既往使用降糖药物或确诊肺癌的病例。通过计算风险比和置信区间评估肺癌风险，并采用倾向性评分匹配控制混杂因素。结果显示，除α-葡萄糖苷酶抑制剂外，所有非胰岛素类降糖药物均较胰岛素显著降低肺癌风险，其中GLP-1RAs的风险降低幅度最大（HR: 0.49, 95% CI: 0.41, 0.59）。在不同组织学类型、种族、性别及吸烟状态的患者中，GLP-1RAs均表现出稳定的肺癌风险降低作用。这些发现提示，在2型糖尿病管理中，非胰岛素类降糖药物（尤其是GLP-1RAs）可能兼具控制血糖与降低肺癌风险的双重优势。
肿瘤(癌症)患者之家